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Nigeria has withdrawn from the Youth Olympics in the Chinese city of Nanjing, state media reported Saturday, as four African nations battle the worst outbreak of the Ebola virus in decades.

Nigeria’s decision was confirmed by International Olympic Committee (IOC) President Thomas Bach in Nanjing, China’s official Xinhua news agency said.

“We feel sad for the athletes as it will be extremely difficult for them,” Bach said of the Nigerians, Xinhua reported. “They already felt the excitement of living in the Village and now they have to leave -- that’s a very difficult task.”

The decision, which affects three athletes whose names and nationalities were not identified, was made “to ensure the safety of all those participating”, the IOC and Chinese organisers said.

Athletes from the Ebola-affected region of Africa would be excluded from combat sports and aquatic events at the Youth Olympic Games, which start today in Nanjing, organisers said.

This comes as the World Health Organisation said the scale of the Ebola outbreak in West Africa had been "vastly" underestimated, requiring a massive escalation of efforts to combat the deadly disease.

The World Health Organization said Friday the death toll from the worst epidemic of the disease in four decades has climbed to 1,145 in the afflicted countries.

The majority were in Guinea, Sierra Leone and Liberia, while four people have died in Nigeria.

Sierra Leone's National Olympic Committee said earlier this week it had been asked not to send a delegation to China. Nigeria said it was in the process of sending home a delegation of 19 officials and athletes who arrived earlier this week. Liberia decided not to come to China.

Of the four countries affected by Ebola, only Guinea is continuing its participation in the Games, with four athletes competing in track and field events.

The IOC said all delegations were welcome, although athletes from the affected region would be subject to regular temperature and physical assessments. The exclusions from combat sports and aquatic events were only expected to affect three athletes.

The 12-day Youth Olympics are expected to attract more than 3,000 athletes aged 15 to 18 from around the world.

The WHO acknowledged on its website that the situation was worse than previously thought. "Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak," it said.

"The WHO is coordinating a massive scaling up of the international response, marshalling support from individual countries, disease control agencies, agencies within the United Nations system, and others."

International agencies were looking into emergency food drops and truck convoys to reach hungry people in Liberia and Sierra Leone cordoned off from the outside world to halt the spread of the virus, said Tim Evans, senior director for health at the World Bank.

Guinea, where 377 people have died, has declared a public health emergency and was sending health workers to all affected border points, an official said.

Sierra Leone has declared Ebola a national emergency, as has Liberia, which is hoping that two of its doctors diagnosed with Ebola can start treatment with some of the limited supply of the experimental drug ZMapp.

Nigeria has also declared a national emergency, but has so far escaped the levels of infection seen in the three other countries.